MEDICARE: BECKER & SORENSEN, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	517	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558545152
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BECKER & SORENSEN, PC

Provider Business Mailing Address
First Line	:	2626 WEST MAIN STREET
Second Line	:	SUITE 4
City	:	RAPID CITY
State	:	SD
Zip	:	57702-2496
Country	:	US
Telephone Number	:	605-399-3811
Fax Number	:	605-399-3845

Provider Business Practice Location Address
First Line	:	2626 WEST MAIN STREET
Second Line	:	SUITE 4
City	:	RAPID CITY
State	:	SD
Zip	:	57702-2496
Country	:	US
Telephone Number	:	605-399-3811
Fax Number	:	605-399-3845

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	CATHLEEN JAMES
Credential	:
Telephone Number	:	605-399-3811

Provider Enumeration Date	:	12/19/2007
Last Update Date	:	01/16/2013

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